Steps In Time

I have a new favorite Republican. His name is Adam O'Neal, and he is the mayor of a town called Belhaven in the newly insane state of North Carolina. Belhaven is not a very big place, but it has a very big problem because the governor and the state legislature of the newly insane state of North Carolina don't think it's worth it to keep people alive and healthy in places like Belhaven, with its 1,700 residents.

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Vidant Health, the not-for-profit, Greenville, N.C.-based parent of Pungo, officially de-designated (PDF) and closed the hospital July 1. In September, Vidant originally announced it would shut down Pungo in April because of financial problems and replace it with a new 24-hour, multispecialty care clinic. After a series of negotiations, Vidant and Belhaven reached a mediation agreement in which Vidant would operate Pungo until July 1, with the town finding a new owner and operator by then. That deadline has come and gone, resulting in the closure of Pungo. Roger Robertson, president of Vidant's community hospital division, said in a release that Vidant will still build the new multispecialty clinic in Belhaven. But Belhaven no longer has an emergency room, meaning area residents will have to travel as much as 80 miles to receive hospital care.

The hospital in question lost a little over a million bucks last year. Its "non-profit" parent company took in $1.6 billion-with-a-B in revenues last year. Mayor O'Neal finds this discrepancy worthy of note, especially since the decision to close the hospital may already have produced casualties.

The hospital's closure may have already claimed a life: Last week, 48-year-old Portia Gibbs of Hyde County died after suffering a diabetic episode that triggered a heart attack. Vidant Pungo was 47 miles from the Gibbs' home, but now the closest hospital is 75 miles away. Emergency responders decided to wait for a helicopter instead of driving—but it took over an hour to arrive, and by then it was too late. Though some emergency responders have questioned whether Gibbs would have survived even if Vidant Pungo was still open, her grieving family points out that they will never know.

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In any event, Mayor O'Neal has no illusions about who's on the other side of the issue.

"You have laws to stop people who are immoral or have motives that are not for the public good," O'Neal said. "We have an immoral, greedy nonprofit that is taking our hospital away."

And his career in national Republican politics goes up in flames.

Of course, this would be mitigated a little had the newly insane state of North Carolina accepted the FREE MONEY! it could have had through the provisions of the Affordable Care Act. But Governor Pat McCrory, and the state legislature, of the newly insane state of North Carolina, decided that they were not going to allow the shackles of healthy poor people to be placed on liberty (!), so that's how that goes. No matter, Mayor O'Neal has come up with his own solution to the problem of illustrating how his constituents are being ground up between the upper millstone of monopoly power and the nether millstone of political nihilism. He's gone out for a walk.

To Washington.

To register a complaint.

The mayor of a small North Carolina town began a 14-day, 273-mile walk Monday to Washington-an action he hopes will reopen his local hospital and draw attention to other struggling nonurban facilities across the nation. "You can't let rural hospitals close across the country. People die," Adam O'Neal, the Republican mayor of Belhaven, N.C., told Modern Healthcare as he walked Tuesday morning.

Mayor O'Neal was sent on his way by the Reverend William Barber, the head of the North Carolina NAACP and the driving force behind the state's Moral Monday movement, and a man who knows a civil rights issue when he sees one.

O'Neal and others charge that the hospital's closing violates the Civil Rights Act of 1964. The NC NAACP filed a complaint under the law's Title VI banning discrimination by government agencies that receive federal funds, arguing that the hospital's closing would disproportionately affect minorities. The Department of Justice offered mediation, and Vidant Health agreed to work out a settlement allowing the hospital to be returned to the community—but then shut its doors anyway. The NAACP refiled the federal complaint.

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These hospitals do staggeringly good work coping with unique problems despite staggeringly limited resources. The rural poor exist largely off-stage in our politics because, for decades, people have found it convenient to put an "urban" face on American poverty, in large part because the people who found that convenient don't believe in any help for the poor except for imaginary Jesus bootstraps and they knew that the foundational racism in the country would help them sell their arguments better than they could. (That was why when LBJ, the old scoundrel, was trying to sell the country on Medicaid and the rest of the Great Society, most of the visuals were with him in Appalachia and in other places where the poor people were mainly white. He was smarter than the professsional bigots. Always was. If he'd only known he was smarter than the generals, too. Oh, well...)

However, the rural poor, black and white, suffer all the health consequences of endemic poverty as do poor people everywhere. And, because so many of the rural poor live in states where taking the FREE MONEY! from the Kenyan Usurper is one step above selling the Statue of Liberty to Somali pirates, the problems are going to get worse, and not better, and Mayor O'Neal knows it.

Rural health advocates believe closures such as Pungo are likely to continue as the year drags on. "It's tragic obviously for the patients and the community," said Maggie Elehwany, vice president of government affairs and policy for NRHA. "And it's not the only story we're going to hear like this. That's the sad part." By the end of Tuesday, O'Neal plans to be in Ahoskie, N.C., a town with another Vidant facility: Vidant Roanoke-Chowan Hospital. He is optimistic his town's hospital will eventually reopen, but he wants a quick turnaround. "When people start dying, I'm going to feel somewhat responsible in some way," O'Neal said. "And I can't let that happen."

This man clearly has no future in the conservative movement. But, if he happens to come through your town, walk a while with him. There's a blessing in it, I'm thinking.

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